Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyFeasibility of measuring myocardial performance index of the right ventricle in anesthetized patients.
Myocardial performance index, the sum of the 2 isovolumic times divided by the ejection time, contains information on global systolic and diastolic function. This study was performed to determine the feasibility of right ventricular myocardial performance index measurements if measured by transesophageal echocardiography in patients under general anesthesia and positive-pressure ventilation. ⋯ This finding questions the use of right ventricular myocardial performance index measurements in anesthetized patients under positive-pressure ventilation.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
ReviewClinical update in cardiac imaging including echocardiography.
Volumetric determinations by cardiac magnetic resonance imaging after tetralogy of Fallot repair may more accurately assess significant right ventricular dilation and pulmonary regurgitation to guide timing of pulmonary valve replacement. Recent guidelines by the American and European Societies of Echocardiography have summarized the clinical approach to valvular stenosis. They emphasize aortic stenosis given its high incidence and assessment confounders such as left ventricular function, aortic regurgitation, systemic hypertension, and mitral regurgitation. ⋯ At the time of mitral surgery, moderate or greater tricuspid regurgitation should be corrected, preferably by rigid annuloplasty. Recent evidence also supports tricuspid annuloplasty for an annular diameter >35 mm regardless of regurgitation severity. Although repair is preferred, tricuspid replacement also has acceptable outcomes.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyValidity of an arterial pressure waveform analysis device: does the puncture site play a role in the agreement with intermittent pulmonary artery catheter thermodilution measurements?
The measurement of cardiac output is a key element in the assessment of cardiac function. Recently, a pulse contour analysis-based device without need for calibration became available (FloTrac/Vigileo, Edwards Lifescience, Irvine, CA). This study was conducted to determine if there is an impact of the arterial catheter site and to investigate the accuracy of this system when compared with the pulmonary artery catheter using the bolus thermodilution technique (PAC). ⋯ The FloTrac/Vigileo system was shown to not produce exactly the same CO data when used in radial and femoral arteries, even though the percentage error was close to the clinically acceptable range. Thus, the impact of the introduction site of the arterial catheter is not negligible. The agreement with thermodilution was low.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyInadequate visualization and reporting of ventricular function from transthoracic echocardiography after cardiac surgery.
The purpose of this study was to determine the incidence of and risk factors for inadequate reporting of ventricular function from transthoracic echocardiography after cardiac surgery. ⋯ Transthoracic imaging is often inadequate in patients who have undergone recent cardiac surgery. Patient and surgical characteristics influence reporting of right and left ventricular function.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyCardiac index validation using the pressure recording analytic method in unstable patients.
The authors investigated the accuracy and precision of the pressure recording analytic method (PRAM) in cardiac index measurement compared with thermodilution in unstable patients, a setting in which minimally invasive monitoring devices often fail. ⋯ This study showed that PRAM, a minimally invasive method for cardiac index assessment, is clinically useful even in unstable patients such as those receiving intra-aortic balloon pump and/or ongoing high doses of a inotropic drugs because of a low cardiac output syndrome but without atrial fibrillation.